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Body Art Inspe <br /> ce Report Date: <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: 52 QUI I I f) <br /> (209)468-3420 <br /> p;. Program <br /> www.sioov.org/ehd <br /> Element: LA p 3 <br /> Facility Name Address City Zip Code <br /> Living Water Studios 1371 e.yosemite ave. Manteca 95336 <br /> Name of Permit/Registration Holder Permit Exp. Date Time In Time Out Inspection Type <br /> Thomas Shea Initial Consult. <br /> The above facility is inspected for compliance with Division 104, Part 15,Chapter 7 of California Health and Safety Code(HSC). <br /> V=Violation C=Corrected On Site <br /> V CLEANING AND STERILIZATION C V MACHINE SAFETY AND SANITATION cont.) C <br /> ❑ 1 Autoclave:approved and effective-passed integrator ❑ ❑ 22.T'arts replaced between clients-grommets,elastic bands, ❑ <br /> testetc. <br /> ❑ <br /> Items washed,disinfected,packaged,labeled,and 2' sterilized El CROSS-CONTAMINATION <br /> ❑ 3. Autoclave loaded correctly/packages allowed to dry ❑ ❑ 23. Workstation/procedure area decontaminated ❑ <br /> ❑ 4. Integrators used/monthly spore testflog maintained ❑ ❑ 24. Appropriate chemical disinfectant used <br /> Decontamination/sanitation area separated and supplied El <br /> 5' ElChemical used: <br /> appropriately <br /> 0 6. <br /> p ro riatel <br /> Invoices and log kept for disposable,pre-sterilized <br /> ® 6• equipment C3 25. Disinfectant used appropriately/sufficient contact time <br /> ElSharps containers labeled, used,and disposed of <br /> ® 7' appropriately <br /> ❑ [Wet contact time provided: <br /> ❑ <br /> Jewelry,tattoo and piercing equipment-clean and 8' El 111126. Barriers used <br /> sterilized <br /> Products applied to skin are single use/dispensed <br /> PRACTITIONER HEALTH AND HYGIENE El 27' asepticallyEl <br /> ❑ 9. No eating,drinking or smoking-clean clothes ❑ ❑ 28. Storage of inks,pigments, needles,tubes,etc. ❑ <br /> ❑ 10. Hands washed effectively and timely ❑ ❑ 29. Jewelry, Inks,Needles etc approved and used correctly ❑ <br /> Handwashing facilities properly supplied and accessible,® Cross-contamination avoided during all phases of 11. warm water El ❑ 30. procedure <br /> El <br /> ❑ 12. Hepatitis B vaccination ❑ BEST BUSINESS PRACTICES <br /> ❑ 13. Bloodborne Pathogen trainingEl ® 31. Areas separated/no living or sleeping quarters ❑ <br /> Source: ® 32. Floors and walls clean and in good repair,adequate light ❑ <br /> Appropriate personal protective equipment available and ❑ Workstation,surfaces,including chairs,armrests,etc.in El❑ 14. used El 33' good repair <br /> CUSTOMERS/CLIENTS ❑ 34. Permit/registration posted ❑ <br /> Branding is completed with no other customers in <br /> El 15. ❑ ® 35. Operation and employee training records present E]rocedure area <br /> ❑ 16. Customers eighteen(18)years of age or older ❑ COMPLIANCE AND ENFORCEMENT <br /> ❑ 17. Skin adequately prepared for procedure ❑ ❑ 36. Plan(s)submitted for review ❑ <br /> ® <br /> Client records approved and available-Consent form 18. and questionnaire El El37. Permits obtained and available ❑ <br /> ® 19. Appropriate aftercare instructions given to client ❑ ❑ 38. Impoundment ❑ <br /> MACHINE SAFETY AND SANITATION ❑ 39. Hearing scheduled ❑ <br /> ❑ 20. Safe machine design ❑ ❑ 40. Closure ❑ <br /> ❑ 21. Machines cleaned and disinfected between clients ❑ ❑ 41. ❑ <br /> Received b (Print): Thomas Shea Received by(Signature): m6kitalL Phone: 209 608-1784 <br /> Specialist(Print): Benjamin Escotto,Sr REHS Specialist(Signature): Phone: 209 468-3178 <br /> 00 <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 1 of 2 <br /> EH-03/2015 <br />